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Zhang N, Teng B, Lu X, Shi L, Liu L, Zhou F, Jiang N, Zhang X, Wang C, Shen S, Zheng R, Zhang S, Wang Y, Hu Y, Zhang B, Zhang Q, Wang L. Exploring the neural mechanisms underlying achalasia: A study of functional connectivity and regional brain activity. Neuroimage 2023; 284:120447. [PMID: 37949257 DOI: 10.1016/j.neuroimage.2023.120447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND AND AIMS The pathophysiology of achalasia, which involves central nuclei abnormalities, remains unknown. We investigated the resting-state functional MRI (rs-fMRI) features of patients with achalasia. METHODS We applied resting-state functional MRI (rs-fMRI) to investigate the brain features in patients with achalasia (n = 27), compared to healthy controls (n = 29). Focusing on three regions of interest (ROIs): the dorsal motor nucleus of the vagus (DMV), the nucleus ambiguus (NA), and the nucleus of the solitary tract (NTS), we analyzed variations in resting-state functional connectivity (rs-FC), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo). RESULTS Achalasia patients demonstrated stronger functional connectivity between the NA and the right precentral gyrus, left postcentral gyrus, and left insula. No significant changes were found in the DMV or NTS. The fMRI analysis showed higher rs-FC values for NA-DMV and NA-NTS connections in achalasia patients. Achalasia patients exhibited decreased fALFF values in the NA, DMV, and NTS regions, as well as increased ReHo values in the NA and DMV regions. A positive correlation was observed between fALFF values in all six ROIs and the width of the barium meal. The NTS fALFF value and NA ReHo value displayed a positive correlation with integrated relaxation pressure (IRP), while the ReHo value in the right precentral gyrus showed an inverse correlation with the height of the barium meal. CONCLUSIONS Abnormal rs-FC and regional brain activity was found in patients with achalasia. Our study provides new insights into the pathophysiology of achalasia and highlights the potential of rs-fMRI in improving the diagnosis and treatment of this condition.
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Affiliation(s)
- Nina Zhang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China; Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Binyu Teng
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinyi Lu
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Liangliang Shi
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Li Liu
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Fan Zhou
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Ni Jiang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Xin Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Cong Wang
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Shanshan Shen
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Ruhua Zheng
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Shu Zhang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yi Wang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yuzheng Hu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Bing Zhang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Qipeng Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, Institute for Brain Sciences, School of Life Sciences, Nanjing University, Nanjing, Jiangsu, China
| | - Lei Wang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.
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2
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Chang YC, Chen CM, Lay IS, Lee YC, Tu CH. The effects of laser acupuncture dosage at PC6 (Neiguan) on brain reactivity: a pilot resting-state fMRI study. Front Neurosci 2023; 17:1264217. [PMID: 37901421 PMCID: PMC10600496 DOI: 10.3389/fnins.2023.1264217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Previous studies indicated that laser acupuncture (LA) may effectively treat various medical conditions. However, brain responses associated with LA intervention have not been fully investigated. This study is focused on the effect of LA with different energy density (ED) in brain using resting-state functional magnetic resonance imaging (fMRI). We hypothesized that different ED would elicit various brain responses. We enrolled healthy adults participants and selected bilateral PC6 (Neiguan) as the intervention points. LA was applied, respectively, with ED of 0, 7.96, or 23.87 J/cm2. Two 500-s resting-state fMRI scans were acquired before and after intervention, respectively. The functional connectivity (FC) was calculated between autonomic nerve system-regulation associated brainstem structures and other brain regions. Compared to other dosages, the FC between rostral ventrolateral medulla and orbitofrontal cortex has more enhanced; the FC between caudal ventrolateral medulla, nucleus of the solitary tract/nucleus ambiguus, and dorsal motor nucleus of the vagus and somatosensory area has more weakened when ED was 23.87 J/cm2. Different dosages of LA have demonstrated varied regions of FC changes between regions of interest and other brain areas, which indicated that variations in EDs might influence the clinical efficacy and subsequent impacts through distinct neural pathways within the brain.
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Affiliation(s)
- Yi-Chuan Chang
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Beigang Hospital, Yunlin, Taiwan
| | - Chun-Ming Chen
- Department of Medical Imaging, China Medical University Hospital, Taichung, Taiwan
| | - Ing-Shiow Lay
- Department of Chinese Medicine, China Medical University Beigang Hospital, Yunlin, Taiwan
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chen Lee
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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3
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Dagenais R, Mitsis GD. Non-invasive estimation of arterial blood pressure fluctuations using a peripheral photoplethysmograph inside the MRI scanner. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083179 DOI: 10.1109/embc40787.2023.10340020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The blood-oxygen-level-dependent (BOLD) signal measured by functional magnetic resonance imaging (fMRI) is modulated by neural activity through the neurovascular coupling effect, as well as non-neural factors of physiological origin such as heart rate, respiration, and arterial blood pressure (ABP). While the former two effects have been previously characterized, the modulation of the BOLD signal by ABP fluctuations is still poorly understood. This is largely due to the difficulty of obtaining reliable ABP measurements in the MRI environment. Here, we propose a combined experimental and mathematical modeling framework to estimate ABP fluctuations inside the MRI scanner using photoplethysmography (PPG). Specifically, we used concurrent PPG and ABP measurements obtained outside the scanner to train the mathematical model and applied it to PPG measurements obtained inside the MRI scanner. Our results suggest good agreement between the model-predicted and experimentally measured ABP fluctuations and region specific correlations with the BOLD fluctuations.
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4
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Panerai RB, Brassard P, Burma JS, Castro P, Claassen JA, van Lieshout JJ, Liu J, Lucas SJ, Minhas JS, Mitsis GD, Nogueira RC, Ogoh S, Payne SJ, Rickards CA, Robertson AD, Rodrigues GD, Smirl JD, Simpson DM. Transfer function analysis of dynamic cerebral autoregulation: A CARNet white paper 2022 update. J Cereb Blood Flow Metab 2023; 43:3-25. [PMID: 35962478 PMCID: PMC9875346 DOI: 10.1177/0271678x221119760] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cerebral autoregulation (CA) refers to the control of cerebral tissue blood flow (CBF) in response to changes in perfusion pressure. Due to the challenges of measuring intracranial pressure, CA is often described as the relationship between mean arterial pressure (MAP) and CBF. Dynamic CA (dCA) can be assessed using multiple techniques, with transfer function analysis (TFA) being the most common. A 2016 white paper by members of an international Cerebrovascular Research Network (CARNet) that is focused on CA strove to improve TFA standardization by way of introducing data acquisition, analysis, and reporting guidelines. Since then, additional evidence has allowed for the improvement and refinement of the original recommendations, as well as for the inclusion of new guidelines to reflect recent advances in the field. This second edition of the white paper contains more robust, evidence-based recommendations, which have been expanded to address current streams of inquiry, including optimizing MAP variability, acquiring CBF estimates from alternative methods, estimating alternative dCA metrics, and incorporating dCA quantification into clinical trials. Implementation of these new and revised recommendations is important to improve the reliability and reproducibility of dCA studies, and to facilitate inter-institutional collaboration and the comparison of results between studies.
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Affiliation(s)
- Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester and NIHR Biomedical Research Centre, Leicester, UK
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, and Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Joel S Burma
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Pedro Castro
- Department of Neurology, Centro Hospitalar Universitário de São João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jurgen Ahr Claassen
- Department of Geriatric Medicine and Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Johannes J van Lieshout
- Department of Internal Medicine, Amsterdam, UMC, The Netherlands and Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham Medical School, Queen's Medical Centre, UK
| | - Jia Liu
- Institute of Advanced Computing and Digital Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen University Town, Shenzhen, China
| | - Samuel Je Lucas
- School of Sport, Exercise and Rehabilitation Sciences and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Jatinder S Minhas
- Department of Cardiovascular Sciences, University of Leicester and NIHR Biomedical Research Centre, Leicester, UK
| | - Georgios D Mitsis
- Department of Bioengineering, McGill University, Montreal, Québec, QC, Canada
| | - Ricardo C Nogueira
- Neurology Department, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Kawagoe-Shi, Saitama, Japan
| | - Stephen J Payne
- Institute of Applied Mechanics, National Taiwan University, Taipei
| | - Caroline A Rickards
- Department of Physiology & Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Andrew D Robertson
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Gabriel D Rodrigues
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Jonathan D Smirl
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - David M Simpson
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
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5
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Gerlach DA, Maier A, Manuel J, Bach A, Hoff A, Hönemann J, Heusser K, Voit D, Frahm J, Jordan J, Tank J. Real‐Time Magnetic Resonance Imaging to Study Orthostatic Intolerance Mechanisms in Human Beings: Proof of Concept. J Am Heart Assoc 2022; 11:e026437. [PMID: 36300662 PMCID: PMC9673621 DOI: 10.1161/jaha.122.026437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Discerning the mechanisms driving orthostatic symptoms in human beings remains challenging. Therefore, we developed a novel approach combining cardiac and cerebral real‐time magnetic resonance imaging, beat‐to‐beat physiological monitoring, and orthostatic stress testing through lower‐body negative pressure (LBNP). We conducted a proof‐of‐concept study in a patient with severe orthostatic hypotension. Methods and Results We included a 46‐year‐old man with pure autonomic failure. Without and during −30 mmHg LBNP, we obtained 3T real‐time magnetic resonance imaging of the cardiac short axis and quantitative flow measurements in the pulmonary trunk and middle cerebral artery. Blood pressure was 118/74 mmHg during supine rest and 58/35 mmHg with LBNP. With LBNP, left ventricular stroke volume decreased by 44.6%, absolute middle cerebral artery flow by 37.6%, and pulmonary trunk flow by 40%. Conclusions Combination of real‐time magnetic resonance imaging, LBNP, and continuous blood pressure monitoring provides a promising new approach to study orthostatic intolerance mechanisms in human beings.
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Affiliation(s)
- Darius A. Gerlach
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany
| | - Andrea Maier
- Department of Neurology University Hospital Aachen Aachen Germany
| | - Jorge Manuel
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany
- Institute for Neuroradiology Hannover Medical School Hannover Germany
| | - Anja Bach
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany
| | - Alex Hoff
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany
| | - Jan‐Niklas Hönemann
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany
- Department of Internal Medicine III, Division of Cardiology, Pneumology, Angiology, and Intensive Care University of Cologne Germany
| | - Karsten Heusser
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany
| | - Dirk Voit
- Biomedical NMR Max Planck Institute for Multidisciplinary Sciences Göttingen Germany
| | - Jens Frahm
- Biomedical NMR Max Planck Institute for Multidisciplinary Sciences Göttingen Germany
| | - Jens Jordan
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany
- Medical Faculty University of Cologne Germany
| | - Jens Tank
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany
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6
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Forstenpointner J, Maallo AMS, Elman I, Holmes S, Freeman R, Baron R, Borsook D. The Solitary Nucleus Connectivity to Key Autonomic Regions in Humans MRI and Literature based Considerations. Eur J Neurosci 2022; 56:3938-3966. [PMID: 35545280 DOI: 10.1111/ejn.15691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/03/2022]
Abstract
The nucleus tractus solitarius (NTS), is a key brainstem structure relaying interoceptive peripheral information to the interrelated brain centers for eliciting rapid autonomic responses and for shaping longer-term neuroendocrine and motor patterns. Structural and functional NTS' connectivity has been extensively investigated in laboratory animals. But there is limited information about NTS' connectome in humans. Using MRI, we examined diffusion and resting state data from 20 healthy participants in the Human Connectome Project. The regions within the brainstem (n=8), subcortical (n=6), cerebellar (n=2) and cortical (n=5) parts of the brain were selected via a systematic review of the literature and their white matter NTS connections were evaluated via probabilistic tractography along with functional and directional (i.e., Granger-causality) analyses. The underlying study confirms previous results from animal models and provides novel aspects on NTS integration in humans. Two key findings can be summarized: (i) the NTS predominantly processes afferent input and (ii) a lateralization towards a predominantly left-sided NTS processing. Our results lay the foundations for future investigations into the NTS' tripartite role comprised of interoreceptors' input integration, the resultant neurochemical outflow and cognitive/affective processing. The implications of these data add to the understanding of NTS' role in specific aspects of autonomic functions.
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Affiliation(s)
- Julia Forstenpointner
- Center for Pain and the Brain, Boston Children's Hospital, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA.,Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Anne Margarette S Maallo
- Center for Pain and the Brain, Boston Children's Hospital, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA
| | - Igor Elman
- Center for Pain and the Brain, Boston Children's Hospital, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA.,Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Scott Holmes
- Center for Pain and the Brain, Boston Children's Hospital, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ralf Baron
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - David Borsook
- Center for Pain and the Brain, Boston Children's Hospital, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA.,Department of Radiology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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7
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Millon EM, Lehrer PM, Shors TJ. Meditation and Aerobic Exercise Enhance Mental Health Outcomes and Pattern Separation Learning Without Changing Heart Rate Variability in Women with HIV. Appl Psychophysiol Biofeedback 2022; 47:27-42. [PMID: 35040014 PMCID: PMC8763305 DOI: 10.1007/s10484-021-09530-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 01/01/2023]
Abstract
Mental and physical (MAP) training targets the brain and the body through a combination of focused-attention meditation and aerobic exercise. The following feasibility pilot study tested whether 6 weeks of MAP training improves mental health outcomes, while enhancing discrimination learning and heart rate variability (HRV) in a group of women living with human immunodeficiency virus (HIV) and other stress-related conditions. Participants were assigned to training (n = 18) or no-training control (n = 8) groups depending on their ability and willingness to participate, and if their schedule allowed. Training sessions were held once a week for 6 weeks with 30 min of meditation followed by 30 min of aerobic exercise. Before and after 6 weeks of training, participants completed the Behavioral Pattern Separation Task as a measure of discrimination learning, self-report questionnaires of ruminative and trauma-related thoughts, depression, anxiety, and perceived stress, and an assessment of HRV at rest. After training, participants reported fewer ruminative and trauma-related thoughts, fewer depressive and anxiety symptoms, and less perceived stress (p’s < 0.05). The positive impact on ruminative thoughts and depressive symptoms persisted 6 months after training. They also demonstrated enhanced discrimination of similar patterns of information (p < 0.05). HRV did not change after training (p > 0.05). Combining mental and physical training is an effective program for enhancing mental health and aspects of cognition in women living with HIV, although not necessarily through variance in heart rate.
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Affiliation(s)
- Emma M Millon
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, USA.
| | - Paul M Lehrer
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Tracey J Shors
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, USA.,W.M. Keck Center for Collaborative Neuroscience, Rutgers University, Piscataway, New Jersey, USA
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8
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Gerlach DA, Manuel J, Hoff A, Kronsbein H, Hoffmann F, Heusser K, Ehmke H, Jordan J, Tank J, Beissner F. Medullary and Hypothalamic Functional Magnetic Imaging During Acute Hypoxia in Tracing Human Peripheral Chemoreflex Responses. Hypertension 2021; 77:1372-1382. [PMID: 33641354 DOI: 10.1161/hypertensionaha.120.16385] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Darius A Gerlach
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany (D.A.G., J.M., A.H., H.K., F.H., K.H., J.J., J.T.)
| | - Jorge Manuel
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany (D.A.G., J.M., A.H., H.K., F.H., K.H., J.J., J.T.).,Institute for Neuroradiology, Hannover Medical School, Germany (J.M., F.B.)
| | - Alex Hoff
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany (D.A.G., J.M., A.H., H.K., F.H., K.H., J.J., J.T.)
| | - Hendrik Kronsbein
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany (D.A.G., J.M., A.H., H.K., F.H., K.H., J.J., J.T.).,Institute of Cellular and Integrative Physiology, University Medical Center Eppendorf, Hamburg, Germany (H.K., H.E.)
| | - Fabian Hoffmann
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany (D.A.G., J.M., A.H., H.K., F.H., K.H., J.J., J.T.)
| | - Karsten Heusser
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany (D.A.G., J.M., A.H., H.K., F.H., K.H., J.J., J.T.)
| | - Heimo Ehmke
- Institute of Cellular and Integrative Physiology, University Medical Center Eppendorf, Hamburg, Germany (H.K., H.E.)
| | - Jens Jordan
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany (D.A.G., J.M., A.H., H.K., F.H., K.H., J.J., J.T.).,Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Jens Tank
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany (D.A.G., J.M., A.H., H.K., F.H., K.H., J.J., J.T.)
| | - Florian Beissner
- Institute for Neuroradiology, Hannover Medical School, Germany (J.M., F.B.)
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9
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Qian L, TCW J. Human iPSC-Based Modeling of Central Nerve System Disorders for Drug Discovery. Int J Mol Sci 2021; 22:1203. [PMID: 33530458 PMCID: PMC7865494 DOI: 10.3390/ijms22031203] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 02/07/2023] Open
Abstract
A high-throughput drug screen identifies potentially promising therapeutics for clinical trials. However, limitations that persist in current disease modeling with limited physiological relevancy of human patients skew drug responses, hamper translation of clinical efficacy, and contribute to high clinical attritions. The emergence of induced pluripotent stem cell (iPSC) technology revolutionizes the paradigm of drug discovery. In particular, iPSC-based three-dimensional (3D) tissue engineering that appears as a promising vehicle of in vitro disease modeling provides more sophisticated tissue architectures and micro-environmental cues than a traditional two-dimensional (2D) culture. Here we discuss 3D based organoids/spheroids that construct the advanced modeling with evolved structural complexity, which propels drug discovery by exhibiting more human specific and diverse pathologies that are not perceived in 2D or animal models. We will then focus on various central nerve system (CNS) disease modeling using human iPSCs, leading to uncovering disease pathogenesis that guides the development of therapeutic strategies. Finally, we will address new opportunities of iPSC-assisted drug discovery with multi-disciplinary approaches from bioengineering to Omics technology. Despite technological challenges, iPSC-derived cytoarchitectures through interactions of diverse cell types mimic patients' CNS and serve as a platform for therapeutic development and personalized precision medicine.
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Affiliation(s)
- Lu Qian
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Ronald Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Julia TCW
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Ronald Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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10
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Karemaker JM. Interpretation of Heart Rate Variability: The Art of Looking Through a Keyhole. Front Neurosci 2020; 14:609570. [PMID: 33408610 PMCID: PMC7779618 DOI: 10.3389/fnins.2020.609570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Abstract
The heart may be a mirror of the soul, but the human mind is more than its heart rate variability (HRV). Many techniques to quantify HRV promise to give a view of what is going on in the body or even the psyche of the subject under study. This "Hypothesis" paper gives, on the one hand, a critical view on the field of HRV-analysis and, on the other hand, points out a possible direction of future applications. In view of the inherent variability of HRV and the underlying processes, as lined out here, the best use may be found in serial analysis in a subject/patient, to find changes over time that may help in early discovery of developing pathology. Not every future possibility is bright and shining, though, as demonstrated in a fictional diary excerpt from a future subject, living in a society geared toward preventive medicine. Here implanted biochips watch over the health of the population and artificial intelligence (AI) analyses the massive data flow to support the diagnostic process.
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Affiliation(s)
- John M. Karemaker
- Department of Medical Biology, Section Systems Physiology, Amsterdam University Medical Centers, Amsterdam, Netherlands
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11
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Cantow K, Hummel L, Flemming B, Waiczies S, Niendorf T, Seeliger E. Imagine physiology without imaging. Acta Physiol (Oxf) 2020; 230:e13549. [PMID: 32852085 DOI: 10.1111/apha.13549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Kathleen Cantow
- Institut für vegetative Physiologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Luis Hummel
- Institut für vegetative Physiologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Bert Flemming
- Institut für vegetative Physiologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | - Erdmann Seeliger
- Institut für vegetative Physiologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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Jordan J, Tank J. How Sympathetic Is Sympathetic Enough? Hypertension 2020; 76:672-674. [PMID: 32783753 DOI: 10.1161/hypertensionaha.120.15422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jens Jordan
- From the Institute of Aerospace Medicine, German Aerospace Center (DLR) and University of Cologne, Germany
| | - Jens Tank
- From the Institute of Aerospace Medicine, German Aerospace Center (DLR) and University of Cologne, Germany
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Al-Shafei AI, Musa SM, Rayis DA, Lutfi MF, El-Gendy OA, Adam I. Heart rate variability and hematological parameters in pregnant women. J Clin Lab Anal 2020; 34:e23250. [PMID: 32091186 PMCID: PMC7307359 DOI: 10.1002/jcla.23250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 01/26/2020] [Accepted: 01/30/2020] [Indexed: 12/25/2022] Open
Abstract
Background There are few researches on hematological parameters (hemoglobin, red cell distribution width [RDW], white blood cells [WBCs], mean platelets volume [MPV], and heart rate variability [HRV]). There are no published data on this concept (HRV and hematological parameters) during pregnancy. Methods A cross‐sectional study was conducted at Saad Abul Ela hospital in Khartoum, Sudan during the period of July to August 2018. Pregnant women with singleton, a live baby, were enrolled in this study. Clinical history and examination were performed. HRV (autonomic modulation) was assessed using time and frequency domain HRV indices. Results One hundred and five pregnant women were enrolled. The median (quartile) of the age, parity, and gestational age was 30.0 (25.0‐35.0) years, 1.0 (0‐3.0), and 38.0 (32.0‐39.0) weeks, respectively. While there were positive correlations between hemoglobin and low frequency (LF), RDW and high frequency (HF), WBCs and HF Norm, WBCs and LF/HF, MPV and HF Norm, LF Norm and LF/HF, there was no significant correlation between the hematological (hemoglobin, WBCs, RDW, and MPV) and HRV parameters. Linear regression analysis showed no significant association between age, parity, gestational age, body mass index, hemoglobin, RDW, and HRV variables. The Log10 WBCs were negatively associated with Log10 HF (ms2/Hz). MPV was positively associated with LF Norm and negatively associated with HF Norm. Conclusion The study failed to show significant associations between age, parity, gestational age, hemoglobin, RDW, and HRV variables. The WBCs were negatively associated with HF. MPV was positively associated with LF Norm, and it was negatively associated with HF Norm.
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Affiliation(s)
- Ahmad I Al-Shafei
- Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia
| | - Shaza M Musa
- Faculty of medicine, Najran University, Saudi Arabia
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mohamed F Lutfi
- College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Ola A El-Gendy
- Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia
| | - Ishag Adam
- College of Medicine, Qassim University, Qassim, Saudi Arabia.,Department of Obstetrics and Gynecology, Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia
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Hendriks-Balk MC, Megdiche F, Pezzi L, Reynaud O, Da Costa S, Bueti D, Van De Ville D, Wuerzner G. Brainstem Correlates of a Cold Pressor Test Measured by Ultra-High Field fMRI. Front Neurosci 2020; 14:39. [PMID: 32082112 PMCID: PMC7005099 DOI: 10.3389/fnins.2020.00039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Modern imaging techniques such as blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) allow the non-invasive and indirect measurement of brain activity. Whether changes in signal intensity can be detected in small brainstem regions during a cold pressor test (CPT) has not been explored thoroughly. The aim of this study was to measure whole brain and brainstem BOLD signal intensity changes in response to a modified CPT. Methods BOLD fMRI was measured in healthy normotensive participants during a randomized crossover study (modified CPT vs. control test) using ultra-high field 7 Tesla MRI scanner. Data were analyzed using Statistical Parametric Mapping (SPM) in a whole-brain approach, and with a brainstem-specific analysis using the spatially unbiased infra-tentorial template (SUIT) toolbox. Blood pressure (BP) and hormonal responses (norepinephrine and epinephrine levels) were also measured. Paired t-test statistics were used to compare conditions. Results Eleven participants (six women, mean age 28 ± 8.9 years) were analyzed. Mean arterial BP increased from 83 ± 12 mm Hg to 87 ± 12 mm Hg (p = 0.0009) during the CPT. Whole-brain analysis revealed significant activations linked to the CPT in the right supplementary motor cortex, midcingulate (bilateral) and the right anterior insular cortex. The brainstem-specific analysis showed significant activations in the dorsal medulla. Conclusion Changes in BOLD fMRI signal intensity in brainstem regions during a CPT can be detected, and show an increased response during a cold stress in healthy volunteers. Consequently, BOLD fMRI at 7T is a promising tool to explore and acquire new insights in the comprehension of neurogenic hypertension.
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Affiliation(s)
- Mariëlle C Hendriks-Balk
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Fatma Megdiche
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Laura Pezzi
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Reynaud
- Centre d'Imagerie BioMédicale (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sandra Da Costa
- Centre d'Imagerie BioMédicale (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Domenica Bueti
- Centre d'Imagerie BioMédicale (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Dimitri Van De Ville
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Medical Image Processing Laboratory, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Grégoire Wuerzner
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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